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A Medicare Journey

8/12/2022

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​Navigating the Medicare enrollment process and all that it entails can be tricky.  Read about Leslie’s adventure and take note of her helpful tips. 

​I’m going to share a little secret.  Confidentially, between us girls, I just signed up for Medicare.  (shudder, gasp, you don’t look 65!)  Piece of cake, right? 

The truth…. it was straightforward because I leveraged the team at Chapter.  Chapter is an independent Medicare Advisor endorsed by the NCOA (National Council on Aging).  My advisor was a young man named Dilraj.   Dilraj was incredibly well informed and assisted me with 
  • the process of signing up on the ssa.gov website as well as setting my expectations on how long it can take to get a response and my Medicare number. 
  • information on the supplemental plans available in my area  
  • looking up my prescriptions to determine the appropriate coverage  
  • the numerous links and documents I needed to make an informed decision and make the applications  

Most importantly, he followed up with me so that I completed the process well within my enrollment window. My coverage started without a hitch.  When was the last time someone followed up with you?!  Signing up within the enrollment window is very important!  Here is a handy flowchart that details the process.

I have been a financial advisor for 25+ years, have an RMA certification (retirement management advisor), attended multiple Medicare seminars and assisted my husband with going through the process two years ago.   I still chose to use Chapter rather than one of the myriad of insurance salespeople that somehow knew I was Medicare eligible and were relentless in their solicitations.  Why?  Because Medicare is complicated, and I did not want to take a chance on making a mistake (Same reason I do not change the oil in my car). 

So, what’s the big deal?  Why do I need to know this stuff? 

Medicare comes with choices, deadlines and penalties plus premiums, copays and deductibles.  Hence it is important to get it right. Some things you need to know are 

  • There are two types of Medicare plans, original Medicare and Advantage Medicare.  Knowing which is best for you is critical. 
  • There are enrollment deadlines and penalties.  Penalties can be quite steep and last the rest of the time you are enrolled in Medicare (i.e. your lifetime!).  That can mean years of penalties.  An expensive mistake. 
  • Vision and dental care are not included in original Medicare.   
  • Supplemental policies for original Medicare, prescription plans, vision and dental can vary state to state. 
  • The amount of your Medicare premium is determined by your modified adjusted gross income (MAGI), from two years ago. Yep. You need to know this but also make sure your financial advisor knows this, too.  
  • 98% of all physicians accept Medicare.  The quality of medical advice and service you receive does not have anything to do with Medicare.  Chances are you can keep your current doctors unless you are in an Advantage plan. 
  • Medicare does not discriminate against pre-existing conditions.  
  • Prior to signing up for Social Security, Medicare premiums are billed monthly or quarterly.  Once you are signed up for Social Security the premium is deducted from your monthly SS check. 

Medicare Costs 

There are several websites that include specific information with regard to deductibles, copays, premiums.  Here are a few of them 
  • https://www.medicare.gov/your-medicare-costs Now
  • https://askchapter.org 
  • https://www.ssa.gov/benefits/medicare/ 

Now that my husband and I are enrolled in Medicare (trying hard to stay healthy!) we estimate a 30% savings in our premiums, more than a 90% savings in our deductibles as well as on our prescriptions.  When calculating our new costs and deducting the savings on the premiums, I even added back the supplemental insurance premiums, prescription, dental and vision premiums.  We still come out way ahead. 

Medicare covers about 55-60 million American consumers; 96% of our elderly are covered by Medicare.  It is a very important program for U.S. citizens.  The new Medicare provision allowing Medicare to negotiate drug prices with pharmaceutical companies is a big step forward as is the cap on prescription expense.  Here are a couple of interesting websites that detail the impact of prescription drug spending on Medicare. 
  • 10 Essential Facts About Medicare and Prescription Drug Spending | KFF 
  • How much does Medicare spend on prescription drugs? - USAFacts 

​Please feel free to forward questions to Leslie@Mosaicfi.com 


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